TY - JOUR
T1 - C-arm cone-beam CT-guided percutaneous transthoracic needle biopsy of small (≤ 20 mm) lung nodules
T2 - Diagnostic accuracy and complications in 161 patients
AU - Choi, Jin Woo
AU - Park, Chang Min
AU - Goo, Jin Mo
AU - Park, Yang Kyun
AU - Sung, Wonmo
AU - Lee, Hyun Ju
AU - Lee, Sang Min
AU - Ko, Ji Young
AU - Shim, Mi Suk
PY - 2012/9
Y1 - 2012/9
N2 - OBJECTIVE. The purpose of this study is to retrospectively evaluate the diagnostic accuracy and complications of C-arm cone-beam CT (CBCT) - guided percutaneous transthoracic needle biopsy (PTNB) for small (≤ 20 mm) lung nodules and their possible influencing factors. Materi als and met hods. From March 2009 to July 2010, 161 consecutive patients (77 men and 84 women; mean [± SD] age, 61 ± 11.8 years; range, 29-85 years) with 173 small (≤ 20 mm) lung nodules underwent CBCT-guided PTNB performed by an experienced chest radiologist in a tertiary referral hospital. The diagnostic accuracy, sensitivity, specificity, and complication rates were statistically evaluated, and influencing factors were assessed using univariate and subsequent multivariate analysis. RESULTS. Of 173 nodules (mean size, 15 ± 3.7 mm), 94 (54.3%) were diagnosed as malignant, 69 (39.9%) as benign, and 10 (5.8%) as indeterminate. On PTNB, 160 nodules were correctly diagnosed and three were false-negatives. Diagnostic accuracy, sensitivity, and specificity were 98.2%, 96.8%, and 100%, respectively. No factors significantly decreased diagnostic accuracy. As for complications, pneumothorax, hemoptysis, and chest pain occurred in 55 (31.8%), 25 (14.5%), and two (1.2%) patients, respectively. Multivariate analysis revealed that the presence of emphysema along the needle pathway was a significant risk factor (odds ratio [OR], 10.11), and the occurrence of hemoptysis was a significant protective factor (OR, 0.28) against pneumothorax. Ground-glass nodules were found to be a significant independent risk factor for hemoptysis (OR, 5.10). CONCLUSION. C-arm CBCT-guided PTNB is highly accurate for small lung nodules, and the diagnostic accuracy does not significantly decrease even in technically challenging conditions.
AB - OBJECTIVE. The purpose of this study is to retrospectively evaluate the diagnostic accuracy and complications of C-arm cone-beam CT (CBCT) - guided percutaneous transthoracic needle biopsy (PTNB) for small (≤ 20 mm) lung nodules and their possible influencing factors. Materi als and met hods. From March 2009 to July 2010, 161 consecutive patients (77 men and 84 women; mean [± SD] age, 61 ± 11.8 years; range, 29-85 years) with 173 small (≤ 20 mm) lung nodules underwent CBCT-guided PTNB performed by an experienced chest radiologist in a tertiary referral hospital. The diagnostic accuracy, sensitivity, specificity, and complication rates were statistically evaluated, and influencing factors were assessed using univariate and subsequent multivariate analysis. RESULTS. Of 173 nodules (mean size, 15 ± 3.7 mm), 94 (54.3%) were diagnosed as malignant, 69 (39.9%) as benign, and 10 (5.8%) as indeterminate. On PTNB, 160 nodules were correctly diagnosed and three were false-negatives. Diagnostic accuracy, sensitivity, and specificity were 98.2%, 96.8%, and 100%, respectively. No factors significantly decreased diagnostic accuracy. As for complications, pneumothorax, hemoptysis, and chest pain occurred in 55 (31.8%), 25 (14.5%), and two (1.2%) patients, respectively. Multivariate analysis revealed that the presence of emphysema along the needle pathway was a significant risk factor (odds ratio [OR], 10.11), and the occurrence of hemoptysis was a significant protective factor (OR, 0.28) against pneumothorax. Ground-glass nodules were found to be a significant independent risk factor for hemoptysis (OR, 5.10). CONCLUSION. C-arm CBCT-guided PTNB is highly accurate for small lung nodules, and the diagnostic accuracy does not significantly decrease even in technically challenging conditions.
KW - C-arm cone-beam CT
KW - Lung biopsy
KW - Small pulmonary nodule
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U2 - 10.2214/AJR.11.7576
DO - 10.2214/AJR.11.7576
M3 - Article
C2 - 22915422
AN - SCOPUS:84865593706
SN - 0361-803X
VL - 199
SP - W322-W330
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 3
ER -